A biological background to 'bad' behaviour?

Naughty - or not their fault? ADHD affects two per cent of children in the UK yet the disorder is still hotly contested. Star reporter Rachael Clegg chats to a Sheffield mother of a child with ADHD about what it's like living with the condition and how she copes.

DEBORAH Royston doesn't sleep well, she's constantly shattered, and she has virtually no time to herself.

But she has the patience of a saint.

Her two sons - aged 10 and 13 - each suffer from a variety of behavioural problems. Jack, the younger of the two boys, has autism and a disorder known as pathological demand avoidance syndrome or PDA, a condition in which sufferers tend to avoid everyday demands to a pathological degree.

The elder, Connor, has autism and attention-deficit hyperactivity disorder - ADHD - which means he is hyperactive, impulsive, and has a short attention span.

Deborah admits it is "shattering".

"I don't sleep well as the little one's always waking me up," she told The Star. "I'm constantly listening as to what he's doing in case he wanders downstairs and lets himself out - we have a bolt on the door so they can't let themselves out of the house. I'm constantly shattered."

Everyday jobs which, for most of us, are reasonably straightforward are for Deborah embarrassing, tiring and extremely hard work.

"You take them shopping and one of them will have a paddy and there is no reasoning with them," said Deborah, 42, from Hillsborough.

"They'll throw a wobbly and people look at you as if to say, 'Get them under control', but you can't reason with children with these problems."

Many people blame the parents of children with ADHD, on grounds the condition is merely a manifestation of naughtiness and a lack of discipline.

But Deborah says she has tried 'everything'.

"Nothing works. We've confiscated the Xbox from my eldest son - and he's Xbox-mad - but it didn't work. The next time he was naughty he went into his bedroom and brought us the Xbox because he thought that's what happens when he's naughty. It doesn't bother him that he'd be without it. We've tried naughty steps, timout - everything. There's nothing we haven't tried.

"There have been times when I have stormed off into the kitchen and screamed."

Deborah has sought refuge in a north Sheffield-based organisation called Ray of Hope, which supports children with problems such as ADHD, PDA and autism while proving help for their parents.

Jayne Raynor, 42, from Hillsborough, who helps with the group, said: "People don't have a full understanding of how ADHD works. There are two schools of thought - people who think they understand ADHD and people who dismiss it as naughtiness. But it's difficult for these children. They often have a lack of sleep and suffer from high anxiety levels."

Despite accusations that ADHD is a product of environmental findings and lenient parenting, Deborah believes there is a genetic basis for the condition.

Her theory has been backed by controversial research by The University of Cardiff, which showed ADHD, which affects two per cent of children in the UK, has a genetic root.

Researchers looked at DNA from 360 children diagnosed with ADHD and 1,047 children without ADHD - and found 15 per cent of the ADHD group had unique variations in their DNA, compared with seven per cent of the non-ADHD group.

Based on their findings the scientists said the behavioural condition was a brain problem, much like autism, and not, as many believe, a result of a child's environment.

But consultant psychologist at Sheffield Health and Social Trust, Professor Tim Kendall, is wary. "What that research shows is that 85 per cent of children with ADHD have no genetic component to their condition," he points out.

"There are lots of factors. Smoking during pregnancy can have an effect, stress on the mother during pregnancy - for example, if the mother suffers from serious anxiety - that increases the risk of the child developing ADHD.

"Then there are other factors such as whether the child is born into a large family, and serious parental conflict increases risk."

ADHD is also more prevalent among children from backgrounds of low socio-economic status.

"It's a guarantee there will be more kids with ADHD in some parts of Sheffield than others," said Prof Kendall.

"But I don't want to blame parents - most parents do their best. If you have a kid jumping from one thing to another and you're sitting in your house in a poor part of Sheffield, it's difficult to know how to deal with it."

The solution to dealing with ADHD, according to Prof Kendall, is to approach it from an environmental perspective.

"Parents should be offered training programmes, which should link up with a child's school teacher," he says.

But the emphasis on ADHD having a biological basis suggests only drugs can ease the problem.

"There is a real danger people will think you simply give kids Ritalin and that's it.

"Ritalin makes children with ADHD more accessible, and if you're having trouble engaging a child Ritalin can be helpful, but with mild to moderate cases of ADHD psychological treatment and behaviour management should come first."

And while many people believe ADHD to be an excuse for bad behaviour, clinical diagnosis of the condition is much more rigorous.

"Studies show there are identifiable children who show hyperactivity, inattentiveness and impulsion to a significant degree," said Prof Kendall. "If these impairments are manifested in their social, family and educational life, in all three settings we identify them as having ADHD.

"ADHD does have an impact on their function, making children lose friendships, giving their parents hell and creating educational difficulties."

And, while the recent research may reduce the ADHD's stigma for parents, it only increases it for the child.

"They are more likely to see the condition as a burden when, actually, only 15 per cent of children with ADHD will have the condition as adults.

"The concept that it's biological is depressing for children - if we accept it's a result of environmental factors we can do something about it, but if we don't do something to help, the outcome can be disastrous. They can end up with no friends by the time they are 14, or in prison."

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